Microbiology and Parasitology - Lab

Module #16 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

LESSON TITLE: MONONUCLEOSIS, MUMPS AND Materials:

PEDICULOSIS
Pen, paper, index card, book, and class List
LEARNING OUTCOMES:
At the end of the lesson, the nursing student can: Reference:
1. Describe what is mononucleosis, mumps and pediculosis;
2. Explain the mode of transmission of mononucleosis, mumps Navales D., (2010). Handbook of Common
rd
and pediculosis; Communicable and Infectious Diseases 3
3. Identify the etiologic agent of mononucleosis, mumps and Edition, Philippines: C&E Publishing Inc.
pediculosis;
4. Enumerate the signs and symptoms of mononucleosis, mumps
and pediculosis; and,
5. Outline the different nursing management of mononucleosis,
mumps and pediculosis.

A. LESSON PREVIEW/REVIEW (5 minutes)

Instruction: As a nurse, what is your main responsibility in preventing the spread of MERS-CoV?
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B.MAIN LESSON (50 minutes)

Content and Skill-Building

Infectious Mononucleosis

Infectious Mononucleosis/Glandular Fever, “Mono” is an acute self-limiting disease of the lymphatic system caused by the
Epstein-Barr virus (EBV), a member of the herpes group.

Incubation Period:
⎯ Ranges from 30 to 50 days in young adults

Mode of Transmission:
⎯ Close personal contact such as “kissing”
⎯ High and lasting immunity usually develops

Clinical Manifestations:
Prodromal symptoms:
⎯ Fatigue, anorexia, inability to concentrate, chilly sensation, and headache
⎯ Fever for 5 days, sore throat and enlarged lymph nodes.
⎯ Exudative tonsillitis characterized by whitish, pasty exudates and a foul-smelling and spreading greenish-gray
membrane, often leaving an ulceration.
⎯ Dysphagia and gum bleeding
⎯ Palatine petechiae

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 Microbiology and Parasitology - Lab
Module #16 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Laboratory Findings:
⎯ Lymphocytosis
⎯ Increase in total IgM levels

Treatment:
⎯ Steroids for bronchodilation
⎯ Antibiotics are of no use
⎯ Bed rest and fluids

Complications:
⎯ Pneumonia or pneumonitis
⎯ Meningitis, encephalitis, and
⎯ Guillain-Barre syndrome a rapid-onset muscle weakness caused by the immune system damaging the peripheral
nervous system. The initial symptoms are typically changing in sensation or pain along with muscle weakness,
beginning in the feet and hands.

Management:
⎯ Proper disposal of oral secretions.
⎯ Bed rest and refrain from strenuous activity.
⎯ Cooling measures for febrile patients.
⎯ Soft diet and increased fluid intake.

Mumps

Mumps/Infectious Parotitis/ Epidemic Parotitis is an acute viral disease manifested by the swelling of one or both parotid
glands, with occasional involvement of other glandular structures, particularly the testes in males.

Causative Agent: Paramyxovirus

Incubation period: 14 to 25 days

Period of communicability:
⎯ Communicable six days before and nine days after the onset of parotid gland swelling.
⎯ 48-hour period immediately preceding the onset of parotitis – is the highest communicability

Clinical Manifestations:
⎯ Headache, otalgia (ear pain), anorexia
⎯ Fever
⎯ Swelling of the parotid gland (Parotid glands are located in front of and below both ears.)

Complications:
⎯ Orchitis is the swelling of the testes and are tender during palpation
⎯ Oophoritis could manifest as pain and tenderness in the abdomen.
⎯ Mastitis is the infection of the breast tissue
⎯ Nuchal rigidity or neck stiffness
⎯ Deafness

Diagnostic Tests:
⎯ Compliment fixation test shows a presumptive evidence of infection
⎯ Hemo-agglutination inhibition

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 Microbiology and Parasitology - Lab
Module #16 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

⎯ Neutralization test determines immunity to mumps

⎯ Isolation of virus from the pharynx
⎯ Serum amylase determination most useful test in making an early presumptive diagnosis of mumps

Treatment:
⎯ Anti-viral drugs
⎯ NSAIDS for pain relief
⎯ Application of hot or cold compress

Nursing Management:
⎯ Isolation using single-occupancy room.
⎯ Susceptible individuals must use masks, and wash hands regularly.
⎯ Provide oral care.
⎯ Bed rest
⎯ Diversionary activities
⎯ Diet: acidic foods must be avoided
⎯ Soft and semisolid foods

Prevention:
⎯ MMR
⎯ Isolation of patient

Pediculosis
Pediculosis is the infestation with the human head-and-body-louse.

Causative Agent: Pediculus Humanos with two subspecies:

⎯ P.H. Capitis (head louse)
⎯ P.H Humanos (body louse)
⎯ They are now ectoparasites whose only know hosts are humans.

Life Cycle
The life cycle of the head louse has three stages: egg, nymph, and adult.

Eggs
⎯ Nits are head lice eggs.
⎯ They are hard to see and are often confused for dandruff or hair spray droplets.
⎯ Nits are laid by the adult female and are cemented at the base of the hair shaft nearest the scalp.
⎯ Nits take about 1 week to hatch (range 6 to 9 days).
⎯ Viable eggs are usually located within 6 mm of the scalp.
Nymphs
⎯ The egg hatches to release a nymph.
⎯ The nit shell then becomes a more visible dull yellow and remains attached to the hair shaft.
⎯ The nymph looks like an adult head louse, but is about the size of a pinhead.
⎯ Nymphs mature after three molts and become adults about 7 days after hatching.
Adults:
⎯ The adult louse is about the size of a sesame seed, has 6 legs (each with claws), and is tan to grayish-white
⎯ In persons with dark hair, the adult louse will appear darker.
⎯ Females are usually larger than males and can lay up to 8 nits per day.
⎯ Adult lice can live up to 30 days on a person’s head. To live, adult lice need to feed on blood several times daily.
Without blood meals, the louse will die within 1 to 2 days off the host.

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 Microbiology and Parasitology - Lab
Module #16 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Body lice
⎯ Body lice are morphologically similar to head lice.
⎯ They have a different life cycle, whereas body lice reside on and lay their eggs on the clothing and fomites of infected
individuals and migrate to the human body to feed.

Modes of Transmission:
⎯ The main mode of transmission of head lice is contact with a person who is already infested (i.e., head-to-head
contact).
⎯ Contact is common during play (sports activities, playgrounds, at camp, and slumber parties) at school and at home.
⎯ Less commonly, transmission via fomites may occur with regards to head lice (more common with body lice).

Clinical Manifestation
⎯ The majority of head lice infestations are asymptomatic.
⎯ When symptoms are noted they may include a tickling feeling of something moving in the hair, itching, caused by an
allergic reaction to louse saliva, and irritability.
⎯ Secondary bacterial infection may be a complication. Body lice can serve as vectors for Rickettsia prowazekii
(epidemic typhus), Bartonella quintana (trench fever), and Borrelia recurrentis (louse-borne relapsing fever).

Treatment:
⎯ Treatment for head lice include both over-the-counter and prescription shampoos, creams, and lotions.

Prevention:
⎯ Wash clothes, beddings, and towels with hot water.
⎯ Soak combs and brushes inn hot water for 5-10 minutes.
⎯ Vacuum the floor and furniture, particularly where you sat or lay.
⎯ If there are items that you cannot wash, seal them in a plastic bag for two weeks.

To prevent children from spreading lice:

⎯ Teach children to avoid head-to-head contact during play and other activities.
⎯ Teach children not to share clothing and other items that they put on their head, such as headphones, hair ties and
helmets.

CHECK FOR UNDERSTANDING (30 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 30 minutes for this activity:

Multiple Choice

1. Which of the following is a self-limiting disease of the lymphatic system caused by the Epstein-Barr virus?
a. Infectious mononucleosis
b. Mumps
c. Measles
d. Pneumonia
ANSWER: ________
RATIO:___________________________________________________________________________________________
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 Microbiology and Parasitology - Lab
Module #16 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

2. Which of the following is a rapid-onset muscle weakness caused by the immune system damaging the peripheral
nervous system?
a. Myasthenia gravis
b. Guillain-Barre syndrome
c. Stroke
d. ALS
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

3.. What do you call the acute viral disease manifested by the swelling of one or both parotid glands?
a. Infectious Parotitis
b. Epidemic Parotitis
c. Mumps
d. All mentioned
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

4. What is the causative agent of mumps is?

a. Paramyxovirus
b. Bordetella
c. Hemophilus influenzae
d. Zoster virus
ANSWER: ________
RATIO:___________________________________________________________________________________________
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5. Mumps is communicable in?

a. 24-hour period immediately preceding the onset of parotitis
b. 48-hour period immediately preceding the onset of parotitis
c. 36-hour period immediately preceding the onset of parotitis
d. 72-hour period immediately preceding the onset of parotitis
ANSWER: ________
RATIO:___________________________________________________________________________________________
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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.

1. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
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 Microbiology and Parasitology - Lab
Module #16 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

2. ANSWER: ________
RATIO:_______________________________________________________________________________________
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3. ANSWER: ________
RATIO:_______________________________________________________________________________________
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4. ANSWER: ________
RATIO:_______________________________________________________________________________________
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5. ANSWER: ________
RATIO:_______________________________________________________________________________________
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C. LESSON WRAP-UP (5 minutes)

AL Activity: Minute Paper

Instruction:
1. Reserve a few minutes at the end of class session. Leave enough time to ask the questions, to allow students to
respond, and to collect their responses.
2. Pass out slips of paper on index cards for students to write on. You may also ask students to bring out and write on a
half sheet of paper instead.
3. Collect the responses as or before students leave. One way is to station yourself at the door and collecting “minute
papers” as student file out.
4. Respond to students’ feedback during the next class meeting or as soon as possible.

1) What was the most useful or the most meaningful thing you have learned this session?
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2) What question(s) do you have as we end this session?
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